Charge Capture Specialist

Pay range: $23.37 - $32.71 per hour, based on experience. In addition, this role is eligible to work remotely from an approved state by St. Charles (please refer to the list). If you do not reside in an approved listed state (or do not plan to relocate to an approved listed state) we request, you do not apply for this particular position. Approved states by St. Charles: Oregon, Arizona, Arkansas, Florida, Idaho, Missouri, Montana, Nevada, New Mexico, North Carolina, Oklahoma, Tennessee, Utah, and Wisconsin. This part-time position comes with a benefits package that includes medical, dental, vision, a 403(b) retirement plan, and a generous Earned Time Off (ETO) program. ST. CHARLES HEALTH SYSTEM JOB DESCRIPTION TITLE: Charge Capture Specialist II REPORTS TO POSITION: Revenue Integrity Leadership DEPARTMENT: Revenue Integrity Department DATE LAST REVIEWED: 06/03/2024 OUR VISION: Creating America’s healthiest community, together OUR MISSION: In the spirit of love and compassion, better health, better care, better value OUR VALUES: Accountability, Caring and Teamwork DEPARTMENT SUMMARY: The Revenue Integrity department focuses on charge capture optimization and documentation improvement through collaboration and education. The Revenue Integrity department provides many services to our multi-hospital and medical group organization focusing on the patient financial experience along the entire continuum of care. Our goal is to deliver delightful, transparent, and seamless experience to our patients and customers that captures and collects the revenue earned by St. Charles Health System (SCHS) in a quality, efficient and timely manner. POSITION OVERVIEW: The Charge Capture Specialist II at SCHS is responsible for validating appropriate charge capture in a quality, efficient and timely manner. Services include but are not limited to the review of accounts to accurately capture charges for assigned Charge Capture Area and other SCHS departments and or cost centers as applicable. This role requires the ability to review medical record documentation to apply accurate charges for services and items/supplies used for patient care, perform basic math and/or time calculations and correct charge capture errors based on SCHS charge capture policies and procedures. This position does not directly manage others but may be asked to review and provide feedback on other caregiver’s work, as well as support other Revenue Integrity Charge Capture Specialist’s with daily work activities. ESSENTIAL DUTIES AND FUNCTIONS: Read and interpret documents contained within the medical record. Accurately determine the charges for the assigned services departments, transferring data to Information Services and Finance as scheduled. Complete accurate and timely charge capture tasks for assigned Charge Capture Area. Deliver excellent customer service in a manner that promotes goodwill, is timely, efficient and accurate when communication between internal/external stakeholders is necessary according to the RI Charge Capture Complexity Matrix. Contribute to and support team in assigned work queue areas designated by leadership. Utilize intermediate to high level research methodologies consistent with the RI Charge Capture Complexity Matrix. Apply intermediate to high level understanding and knowledge of billing, medical coding and charging guidelines when CPT code(s) application is required following Medicare/Medicaid/Payor guidelines, Federal and State regulations and or laws along with SCHS policies and procedures for appropriate charge capture processes. Attend applicable meetings as requested by leadership. Provide requested deliverables as deemed appropriate by leadership. Support the vision, mission, and values of the organization in all respects. Support Lean principles of continuous improvement with energy and enthusiasm, functioning as a champion of change. Provide and maintain a safe environment for caregivers, patients and guests. Conduct all activities with the highest standards of professionalism and confidentiality. Comply with all applicable laws, regulations, policies and procedures, supporting the organization’s corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings. May perform additional duties of similar complexity within the organization as required or assigned. EDUCATION: Required: High School Diploma/GED. Preferred: Associate or bachelor’s degree in an accredited Health Information Technology program or certification in a self-study course from AHIMA, AAPC, Registered Health Information Technician (RHIT) certification or one or more of the following: RHIA, CCA, CCS, CCS-P, CPC, CPC-H, preferred. LICENSURE/CERTIFICATION/REGISTRATION Required: N/A Preferred: Must hold 2 of the following certifications for certification pay: Registered Health Information Technician (RHIT), RHIA, CHRI, CDIP, CPMA, CCA, CBC, CCS, CCS-P, CPC, CPC-H, CIRCC, preferred. EXPERIENCE Required: Two (2) years Revenue Cycle Charge Capture experience required. Related healthcare experience of which one year must have been in a revenue cycle or equivalent role. Preferred: Three (3) years coding and/or medical billing/collections experience with a Health Information Management focus. Over two years Epic or other EHR experience. ADDITIONAL POSITION INFORMATION/SKILLS/ABILITIES Strong interpersonal and communication skills, analytic and organizational skills, critical –thinking and the ability to meet deadlines. Intermediate to high level proficiency and ability in computer applications, including but not limited to electronic medical record(s), MS Office Suite (Word, PowerPoint, Excel, Teams, and Outlook), Windows operating system and Internet. Intermediate to high level knowledge of medical billing, coding and charge capture including but not limited to CMS billing and medical coding guidelines, Federal and State billing and coding guidelines, and insurance payer reimbursement methodologies. Intermediate to high level understanding of CPT-4 code assignment, ICD-10-CM, and ICD-10-PCS code assignment. Intermediate level understanding of NCCI and medical necessity edits and payment methodologies. Intermediate knowledge and usage of internal software research tools relating to modifier and revenue code assignment. Intermediate to high level ability to problem-solving and high-level research skills. Maintain professional knowledge by attending educational workshops, reviewing professional publications, participating in educational opportunities. Research and present educational opportunities to Supervisor as applicable to role. Ability to work independently and collaborate with other team members and leaders. PERSONAL PROTECTIVE EQUIPMENT: Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely. PHYSICAL REQUIREMENTS : Continually (75% or more): Use of clear and audible speaking voice and the ability to hear normal speech level. Frequently (50%): Sitting, standing, walking, lifting 1-10 pounds, keyboard operation. Occasionally (25%): Bending, climbing stairs, reaching overhead, carrying/ pushing or pulling 1-10 pounds, grasping/squeezing. Rarely (10%) : Stooping /kneeling/crouching, lifting, carrying, pushing or pulling 11-15 pounds, operation of a motor vehicle. Never (0%) : Climbing ladder/ step-stool , lifting/carrying/pushing or pulling 25-50 pounds, ability to hear whispered speech level. Exposure to Elemental Factors Never (0%) : Heat , cold, wet/slippery area, noise, dust, vibration, chemical solution, uneven surface. Blood-Borne Pathogen (BBP) Exposure Category No Risk for Exposure to BBP Schedule Weekly Hours: 20 Caregiver Type: Regular Shift: First Shift (United States of America) Is Exempt Position? No Job Family: SPECIALIST Scheduled Days of the Week: As Scheduled (may include weekends and holidays) Shift Start & End Time: 08:00-12:00, 12:00-16:00, 16:00-20:00